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University of Rochester Medical Center Software Engineer Interview Guide

University of Rochester Medical Center Software Engineer interview guide: reported rounds, questions and how candidates describe the process.

The 60-second brief

The Software Engineer role at the University of Rochester Medical Center is pivotal in advancing healthcare technology and improving patient outcomes. As a Software Engineer, you will contribute to the development and maintenance of critical software applications that support health information management, clinical data integration, and operational efficiency. This role not only impacts the technology landscape within the medical center but also enhances the overall patient care experience by ensuring that the systems used by healthcare providers are reliable, efficient, and user-friendly. In this position, you will work collaboratively with cross-functional teams, including data analysts, clinical staff, and IT professionals, to create innovative solutions that address the complex challenges faced in healthcare delivery.

This guide is scoped to a Software Engineer candidate at University of Rochester Medical Center.

Focus areas

  • Salesforce Marketing Cloud
  • Salesforce ecosystem
  • Marketing automation

The University of Rochester Medical Center interview process

University of Rochester Medical Center candidates report 2 rounds over 2-4 weeks. The stages below are what candidates describe, not a published process.

Phone Screening

Initial phone screening to discuss your background and experiences.

What to demonstrate

  • Initial phone screening to discuss your background and experiences
  • Depth in Salesforce Marketing Cloud

How to prepare

  • Be able to walk your CV end to end in two minutes, and say why this company specifically.
  • Have your salary expectations, notice period and location constraints ready, and ask for the rest of the loop in writing.

In-Person Interview

Multiple rounds of in-person interviews with team members and managers.

What to demonstrate

  • Multiple rounds of in-person interviews with team members and managers
  • Depth in Salesforce Marketing Cloud

How to prepare

  • Answer aloud and timed: Describe a challenging technical problem you faced and how you resolved it.
  • Answer aloud and timed: How would you design a system to manage patient data while ensuring compliance with HIPAA?

Where candidates lose points

Understand the Healthcare Context

Familiarize yourself with the healthcare landscape and challenges facing the industry. This knowledge will help you contextualize your technical skills and demonstrate their relevance.

Practice Soft Skills

Prepare to discuss how you collaborate with others and handle conflicts. Strong interpersonal skills are just as critical as technical expertise in this role.

Showcase Continuous Learning

Highlight any recent training, certifications, or personal projects that demonstrate your commitment to staying updated with industry trends and technologies.

Focus on aligning your answers with the values of the University of Rochester Medical Center

This will help you resonate with the interviewers and demonstrate that you are a good cultural fit.

Questions & practice

Write a function to reverse a linked list.

Medium · Coding / Algorithms

Approach

  1. Restate the input: its shape, its size, and what is guaranteed about it.
  2. Name the brute-force solution and its complexity before improving on it.
  3. Choose the data structure from the access pattern, not from familiarity.
  4. State the target complexity and say which constraint rules the naive version out.

Follow-up

  • How does this change if the input no longer fits in memory?
  • What is the worst case, and how likely is it on real data?

How would you implement a search algorithm in a sorted array?

Medium · Coding / Algorithms

Approach

  1. Restate the input: its shape, its size, and what is guaranteed about it.
  2. Name the brute-force solution and its complexity before improving on it.
  3. Choose the data structure from the access pattern, not from familiarity.
  4. State the target complexity and say which constraint rules the naive version out.

Follow-up

  • How does this change if the input no longer fits in memory?
  • What is the worst case, and how likely is it on real data?

Explain the time complexity of your solution and any potential optimizations.

Medium · Coding / Algorithms

Approach

  1. Restate the input: its shape, its size, and what is guaranteed about it.
  2. Name the brute-force solution and its complexity before improving on it.
  3. Choose the data structure from the access pattern, not from familiarity.
  4. State the target complexity and say which constraint rules the naive version out.

Follow-up

  • How does this change if the input no longer fits in memory?
  • What is the worst case, and how likely is it on real data?

Write the update path that detects a concurrent edit

Medium · optimistic concurrency · transactional outbox · audit history

resource carries version INT NOT NULL DEFAULT 1. resource_revision holds revision_id, resource_id, version, actor_user_id, change_kind, patch JSONB, request_id, created_at with UNIQUE (resource_id, version). outbox_event holds aggregate_type, aggregate_id, aggregate_version, event_type, payload, status. A PUT carries the version the client read. Write the exact statements for the single transaction that applies the edit, records the revision and enqueues 'resource.updated', and give the handler's branch on zero affected rows. Then say what PostgreSQL 16 does under READ COMMITTED when two of these updates hit one row at once.

Approach

  1. One transaction, three writes, no network call inside it: UPDATE resource SET title = $3, version = version + 1, updated_at = now() WHERE resource_id = $1 AND tenant_id = $4 AND version = $2; then INSERT the resource_revision row at version $2 + 1; then INSERT the outbox_event row at the same aggregate_version. The event goes to a table rather than a broker because no transaction spans both.
  2. Branch on the affected-row count before doing anything else. Zero has three causes — stale version, wrong tenant, row gone — so re-read once and map to 409 carrying the current version, or 404 for an id outside the caller's tenant, which also stops the endpoint confirming that another tenant's id exists.
  3. State the engine behaviour instead of assuming it. Under READ COMMITTED the second UPDATE blocks on the row lock, and when the first commits PostgreSQL re-evaluates the WHERE clause against the newly committed row, so the version predicate now fails and the statement reports zero rows. Under REPEATABLE READ the identical collision raises SQLSTATE 40001 instead, so the handler must fold both shapes into one conflict response.
  4. Keep UNIQUE (resource_id, version) even though the predicate already serialises writers. It is what makes a lost update unwritable if any other path ever reaches the revision table, and it converts a logic bug into 23505 rather than into a silently missing history row.

Follow-up

  • A client sends the version it read ten minutes ago and the resource has moved three versions. What is in your 409 so it can resolve the conflict without a full re-fetch?
  • Two editors, two disjoint fields, no overlap. Does your answer still refuse the second write, and should it?

Replace offset paging on the resource feed with keyset

Easy · keyset pagination · composite index · sort order

resource holds resource_id, tenant_id, owner_user_id, title, body_ref, version, status ('draft','active','archived','deleted'), created_at, updated_at, deleted_at, with an index on (tenant_id, status, updated_at DESC, resource_id DESC). The listing endpoint returns active resources for one tenant, newest update first, 50 per page, today with LIMIT 50 OFFSET n. Tenants reach page 400 and rows are created while they read. Write the keyset query, define what the cursor carries and how it is encoded, and say which part of the index each predicate uses. Assume PostgreSQL 16.

Approach

  1. Name the two failures separately. OFFSET 20000 makes the server produce and discard 20,000 rows, so page cost grows with depth rather than with page size. Independently, any write that changes how many rows sort above the offset moves the window between two fetches, and the direction decides which anomaly you get: an insert lands at the head of updated_at DESC and pushes already-returned rows down past the boundary, so they are returned a second time; a delete above the offset, or a row whose updated_at is bumped above the cursor, pulls rows up and one is never returned at all. Nothing in the response reveals either.
  2. Write the seek: WHERE tenant_id = $1 AND status = 'active' AND (updated_at, resource_id) < ($2, $3) ORDER BY updated_at DESC, resource_id DESC LIMIT 50. The row-value comparison is one index range rather than a disjunction, and both columns are NOT NULL, which is what makes that comparison well defined.
  3. Map each predicate onto the index: tenant_id and status are equality on the leading columns, (updated_at, resource_id) is the range, and the ORDER BY matches the index order so no Sort node appears and the scan stops after 50 rows. The DESC in the definition only matters for mixed directions — a plain ascending btree on the same columns is read backwards for this query.
  4. Put both sort columns in the cursor and nothing the client can tamper with into another tenant: base64 of (updated_at, resource_id), validated server-side, with tenant_id taken from the principal.

Follow-up

  • The client asks for 'jump to page 400'. What do you offer instead, and what does the honest version cost?
  • Sort order becomes user-selectable across four columns. How many indexes is that, and which would you refuse to add?

What programming languages are you proficient in, and how have you applied them in your projects?

Medium · Technical / Domain Questions

Approach

  1. Clarify what is being asked and what a complete answer contains.
  2. State your assumptions explicitly before working the problem.
  3. Say what you would check first and why it is the highest-information step.
  4. Work from the requirement backwards to the design.

Follow-up

  • What assumption would you test first?
  • How would you know your answer was wrong?

Describe a challenging technical problem you faced and how you resolved it.

Medium · Technical / Domain Questions

Approach

  1. Clarify what is being asked and what a complete answer contains.
  2. State your assumptions explicitly before working the problem.
  3. Say what you would check first and why it is the highest-information step.
  4. Work from the requirement backwards to the design.

Follow-up

  • What assumption would you test first?
  • How would you know your answer was wrong?

How would you design a system to manage patient data while ensuring compliance with HIPAA?

Medium · System Design / Architecture

Approach

  1. Fix the scope first: who calls this, how often, and what they do when it fails.
  2. Name the read and write paths separately; they rarely have the same bottleneck.
  3. Choose a partition key and say what query it makes expensive.
  4. State the consistency you need, and where you are willing to be stale.

Follow-up

  • What breaks first when traffic grows ten times?
  • How does this behave when that dependency is down for an hour?

Describe your approach to designing an API for a healthcare application.

Medium · System Design / Architecture

Approach

  1. Say who the caller is and what they do when the call fails halfway.
  2. Define the identity of a request so a retry cannot double-apply it.
  3. Separate accepted, pending, failed and confirmed; they are different facts.
  4. Design the error taxonomy before the success shape; callers branch on it.

Follow-up

  • What happens if the caller retries after a timeout?
  • How does a client discover it is on an old version of this contract?

What factors do you consider when architecting a system for high availability?

Medium · System Design / Architecture

Approach

  1. Fix the scope first: who calls this, how often, and what they do when it fails.
  2. Name the read and write paths separately; they rarely have the same bottleneck.
  3. Choose a partition key and say what query it makes expensive.
  4. State the consistency you need, and where you are willing to be stale.

Follow-up

  • What breaks first when traffic grows ten times?
  • How does this behave when that dependency is down for an hour?

If a key application goes down during peak hours, what steps would you take to identify and resolve the issue?

Medium · Problem-solving / Case Studies

Approach

  1. Clarify what is being asked and what a complete answer contains.
  2. State your assumptions explicitly before working the problem.
  3. Say what you would check first and why it is the highest-information step.
  4. Work from the requirement backwards to the design.

Follow-up

  • What assumption would you test first?
  • How would you know your answer was wrong?

How would you approach optimizing a slow-performing database?

Medium · Problem-solving / Case Studies

Approach

  1. Clarify what is being asked and what a complete answer contains.
  2. State your assumptions explicitly before working the problem.
  3. Say what you would check first and why it is the highest-information step.
  4. Work from the requirement backwards to the design.

Follow-up

  • What assumption would you test first?
  • How would you know your answer was wrong?

p99 jumped on one listing filter while p50 stayed flat

Medium · query planning · composite index · percentiles

After a release that added an owner_user_id filter to the resource listing, p99 rose from 90 ms to 1.9 s while p50 stayed at 40 ms. Traffic and row counts are unchanged. resource carries the index (tenant_id, status, updated_at DESC, resource_id DESC). The new query filters tenant_id and owner_user_id, orders by updated_at DESC, resource_id DESC, and takes 20 rows. On PostgreSQL, explain the shape of the regression, prove it from a query plan, and give the index you would add.

Approach

  1. Start from the shape. A flat p50 with a moved p99 means a subset of requests changed cost, not all of them, so the first job is naming the subset. Bucket the endpoint's latency by the tenant's row count; the natural hypothesis is that large tenants are a small share of requests and all of the tail.
  2. Get the plan for the new query on a large tenant with EXPLAIN (ANALYZE, BUFFERS). Expect an index scan over the tenant's range, a filter discarding most of it, then a Sort feeding the Limit, possibly reporting Sort Method: external merge Disk. Read actual rows on the scan node, not estimated.
  3. Explain why the existing index cannot serve it. A composite B-tree is seekable only as a left prefix, and with no equality predicate on status the scan cannot treat updated_at as an ordering, because rows in the tenant's range are ordered by status first. Everything matching must be read and sorted before LIMIT 20 can apply, so a tenant with 400,000 rows pays 400,000 rows to return 20.
  4. Add (tenant_id, owner_user_id, updated_at DESC, resource_id DESC). Equality on the first two columns leaves the index ordered by updated_at within that pair, so the plan becomes an index scan that stops after 20 rows with no Sort node. PostgreSQL can scan a B-tree backwards, so the DESC markers matter only if the two sort columns ever disagree in direction; keeping them explicit documents the order the keyset cursor depends on.

Follow-up

  • The endpoint paginates with OFFSET. What does page 500 cost with your index, and what does the keyset version cost?
  • How would you have caught this before release, given that a 10,000-row seed database produces the same plan shape at an unnoticeable cost?

Suggested practice checklist

Built from the rounds and topics University of Rochester Medical Center candidates report.

Day 1 — Map the University of Rochester Medical Center loop

  • Write out the reported sequence: Phone Screening, In-Person Interview.
  • For each round, write one sentence on what it is judging, from the description above, and mark the one you are least ready for.

Deliverable: A one-page map of the 2 reported rounds, with the weakest marked.

Day 2 — Work Salesforce Marketing Cloud

  • Spend the session on Salesforce Marketing Cloud, which University of Rochester Medical Center candidates report being tested on.
  • Write one worked example in Salesforce Marketing Cloud and time yourself on it.

Deliverable: One timed worked example in Salesforce Marketing Cloud.

Day 3 — Work Salesforce ecosystem

  • Spend the session on Salesforce ecosystem, which University of Rochester Medical Center candidates report being tested on.
  • Write one worked example in Salesforce ecosystem and time yourself on it.

Deliverable: One timed worked example in Salesforce ecosystem.

Day 4 — Work Marketing automation

  • Spend the session on Marketing automation, which University of Rochester Medical Center candidates report being tested on.
  • Write one worked example in Marketing automation and time yourself on it.

Deliverable: One timed worked example in Marketing automation.

Day 5 — Answer out loud: Technical / Domain Questions

  • Answer aloud, timed: What programming languages are you proficient in, and how have you applied them in your projects?
  • Answer aloud, timed: Can you explain the software development lifecycle and your experience with Agile methodologies?

Deliverable: Spoken answers to 2 reported Technical / Domain Questions question(s), under time.

Day 6 — Answer out loud: System Design / Architecture

  • Answer aloud, timed: How would you design a system to manage patient data while ensuring compliance with HIPAA?
  • Answer aloud, timed: Describe your approach to designing an API for a healthcare application.

Deliverable: Spoken answers to 2 reported System Design / Architecture question(s), under time.

Day 7 — Answer out loud: Behavioral / Leadership

  • Answer aloud, timed: Tell me about a time you had to work with a difficult team member. How did you handle the situation?
  • Answer aloud, timed: Can you provide an example of how you led a project from inception to completion?

Deliverable: Spoken answers to 2 reported Behavioral / Leadership question(s), under time.

Behavioural preparation

Behavioural rounds judge the decision you made and what it cost.

Can you explain the software development lifecycle and your experience with Agile methodologies?

Medium · Technical / Domain Questions

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?

Tell me about a time you had to work with a difficult team member. How did you handle the situation?

Medium · Behavioral / Leadership

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?

Can you provide an example of how you led a project from inception to completion?

Medium · Behavioral / Leadership

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?

How do you prioritize tasks when working on multiple projects simultaneously?

Medium · Behavioral / Leadership

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?

Describe a time when you had to make a decision with incomplete information.

Medium · Problem-solving / Case Studies

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?